Provider Demographics
NPI:1245905215
Name:BOBBITT, SARA (MS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:BOBBITT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:VA
Mailing Address - Zip Code:24381-4029
Mailing Address - Country:US
Mailing Address - Phone:276-733-1311
Mailing Address - Fax:
Practice Address - Street 1:231 FLOWER GAP RD
Practice Address - Street 2:
Practice Address - City:CANA
Practice Address - State:VA
Practice Address - Zip Code:24317-3896
Practice Address - Country:US
Practice Address - Phone:276-755-3512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist